Lung Cancer: Still Number 1

By Linda Fugate

Linda Fugate is a scientist and writer in Austin, Texas. She has a Ph.D. in Physics and an M.S. in Macromolecular Science and Engineering. Her background includes academic and industrial research in materials science. She currently writes song lyrics and health articles.

Originally Published on EmpowHER - Women's Health Online (http://www.empowher.com) on November 1st, 2010.

Lung cancer still kills more women than breast cancer does. Lung cancer is the leading cancer killer for women, men, Americans, and people worldwide. According to a review from the Mayo Clinic, we are making progress: the incidence is on the decline in the United States. But it's still Number One.

My newspaper this morning had a special pink section on breast cancer. This Number Two cancer killer of women gets ribbons, fund-raisers, annual screenings, and constant attention. Maybe it's time to give a little more attention to Number One.

Approximately 85 to 90 percent of lung cancers are attributed to smoking tobacco products. After a person stops smoking, the risk gradually decreases. Former smokers reach a level of lung health comparable to those who have never smoked if they survive smoke-free for 10 years. But too many of them die before the end of that decade. In a study of 5,000 patients with lung cancer diagnosed between 1997 and 2002, only 25 percent were current smokers and over 60 percent were former smokers and those who had never smoked in their lives.

The American Cancer Society does not yet recommend screening for lung cancer, even for individuals at risk. At first this sounds amazing to me. The Mayo Clinic article reports that the only reasonable hope for curing lung cancer is surgery at a very early stage, before the tumor develops metastases or locally advanced disease. Approximately 70 percent of cases are diagnosed too late for surgery. The overall 5-year survival rate is only 15 percent. So shouldn't we be looking for early lung cancers in smokers and former smokers?

The problem is that 25 to 60 percent of screening CT scans of smokers and former smokers show lung abnormalities. Most of these are not cancer, but it's not yet possible to identify which ones are malignant without invasive biopsy tests. The National Lung Screen Trial is currently underway to collect data on whether spiral CT scans or chest x-rays provide better data.

No one is absolutely safe from lung cancer. About 10 to 15 percent of lung cancers occur in people who have never smoked. Risk factors include air pollution, second hand smoke, and occupational exposure to inhaled carcinogens including asbestos, silica dust, and radioactive particles.

I watched one of my friends die of lung cancer. It was horrible, even with the best available care. I hope we can raise awareness and funding for this Number One cancer killer.

References:

1. Molina JR et al, “Non-small cell lung cancer: Epidemiology, risk factors, treatment, and survivorship”, Mayo Clin Proc. 2008; 83(5): 584-594.
2. National Lung Screening Trial:
http://www.cancer.gov/clinicaltrials/noteworthy-trials/nlst